Integrated tissue positioning and jaw alignment features for surgical stapler

ABSTRACT

An apparatus includes a body, a shaft in communication with the body, and an end effector in communication with the shaft. The end effector is operable to drive staples through tissue. The end effector comprises an anvil and a cartridge. The anvil is operable to move pivotally relative to the cartridge. The cartridge is positioned to drive staples upwardly toward the anvil. The cartridge comprises a plurality of protrusions operable to prevent lateral rocking of the anvil. The plurality of protrusions is pointed toward the anvil. In some versions, an alignment member and/or a lateral stabilization member may be used between the anvil and the cartridge.

BACKGROUND

In some settings, endoscopic surgical instruments may be preferred overtraditional open surgical devices since a smaller incision may reducethe post-operative recovery time and complications. Consequently, someendoscopic surgical instruments may be suitable for placement of adistal end effector at a desired surgical site through the cannula of atrocar. These distal end effectors may engage tissue in a number of waysto achieve a diagnostic or therapeutic effect (e.g., endocutter,grasper, cutter, stapler, clip applier, access device, drug/gene therapydelivery device, and energy delivery device using ultrasound, RF, laser,etc.). Endoscopic surgical instruments may include a shaft between theend effector and a handle portion, which is manipulated by theclinician. Such a shaft may enable insertion to a desired depth androtation about the longitudinal axis of the shaft, thereby facilitatingpositioning of the end effector within the patient. Positioning of anend effector may be further facilitated through inclusion of one or morearticulation joints or features, enabling the end effector to beselectively articulated or otherwise deflected relative to thelongitudinal axis of the shaft.

Examples of endoscopic surgical instruments include surgical staplers.Some such staplers are operable to clamp down on layers of tissue, cutthrough the clamped layers of tissue, and drive staples through thelayers of tissue to substantially seal the severed layers of tissuetogether near the severed ends of the tissue layers. Merely exemplarysurgical staplers are disclosed in U.S. Pat. No. 4,805,823, entitled“Pocket Configuration for internal Organ Staplers,” issued Feb. 21,1989; U.S. Pat. No. 5,415,334, entitled “Surgical Stapler and StapleCartridge,” issued May 16, 1995; U.S. Pat. No. 5,465,895, entitled“Surgical Stapler Instrument,” issued Nov. 14, 1995; U.S. Pat. No.5,597,107, entitled “Surgical Stapler Instrument,” issued Jan. 28, 1997;U.S. Pat. No. 5,632,432, entitled “Surgical instrument,” issued May 27,1997; U.S. Pat. No. 5,673,840, entitled “Surgical Instrument,” issuedOct. 7, 1997; U.S. Pat. No. 5,704,534, entitled “Articulation Assemblyfor Surgical Instruments,” issued Jan. 6, 1998; U.S. Pat. No. 5,814,055,entitled “Surgical Clamping Mechanism,” issued Sep. 29, 1998; U.S. Pat.No. 6,978,921, entitled “Surgical Stapling Instrument Incorporating anE-Beam Firing Mechanism,” issued Dec. 27, 2005; U.S. Pat. No. 7,000,818,entitled “Surgical Stapling Instrument Having Separate Distinct Closingand Firing Systems,” issued Feb. 21, 2006; U.S. Pat. No. 7,143,923,entitled “Surgical Stapling Instrument Having a Firing Lockout for anUnclosed Anvil,” issued Dec. 5, 2006; U.S. Pat. No. 7,303,108, entitled“Surgical Stapling Instrument Incorporating a Multi-Stroke FiringMechanism with a Flexible Rack,” issued Dec. 4, 2007; U.S. Pat. No.7,367,485, entitled “Surgical Stapling Instrument Incorporating aMultistroke Firing Mechanism Having a Rotary Transmission,” issued May6, 2008; U.S. Pat. No. 7,380,695, entitled “Surgical Stapling InstrumentHaving a Single Lockout Mechanism for Prevention of Firing,” issued Jun.3, 2008; U.S. Pat. No. 7,380,696, entitled “Articulating SurgicalStapling Instrument Incorporating a Two-Piece E-Beam Firing Mechanism,”issued Jun. 3, 2008; U.S. Pat. No. 7,404,508, entitled “SurgicalStapling and Cutting Device,” issued Jul. 29, 2008; U.S. Pat. No.7,434,715, entitled “Surgical Stapling Instrument Having MultistrokeFiring with Opening Lockout,” issued Oct. 14, 2008; U.S. Pat. No.7,721,930, entitled “Disposable Cartridge with Adhesive for Use with aStapling Device,” issued May 25, 2010; U.S. Pub. No. 2010/0264193,entitled “Surgical Stapling Instrument with An Articulatable EndEffector,” published Oct. 21, 2010, now U.S. Pat. No. 8,408,439, issuedApr. 2, 2013; and U.S. Pub. No. 2012/0239012, entitled “Motor-DrivenSurgical Cutting Instrument with Electric Actuator Directional ControlAssembly,” published Sep. 20, 2012, now U.S. Pat. No. 8,453,914, issuedJun. 4, 2013. The disclosure of each of the above-cited U.S. Patents andU.S. Patent Publications is incorporated by reference herein.

While the surgical staplers referred to above are described as beingused in endoscopic procedures, it should be understood that suchsurgical staplers may also be used in open procedures and/or othernon-endoscopic procedures. By way of example only, a surgical staplermay be inserted through a thoracotomy and thereby between a patient'sribs to reach one or more organs in a thoracic surgical procedure thatdoes not use a trocar as a conduit for the stapler. Such procedures mayinclude the use of the stapler to sever and close a vessel leading to alung. For instance, the vessels leading to an organ may be severed andclosed by a stapler before removal of the organ from the thoraciccavity. Of course, surgical staplers may be used in various othersettings and procedures.

While various kinds of surgical stapling instruments and associatedcomponents have been made and used, it is believed that no one prior tothe inventor(s) has made or used the invention described in the appendedclaims.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate embodiments of the invention,and, together with the general description of the invention given above,and the detailed description of the embodiments given below, serve toexplain the principles of the present invention.

FIG. 1 depicts a perspective view of an exemplary articulating surgicalstapling instrument;

FIG. 2 depicts a side elevational view of the instrument of FIG. 1;

FIG. 3 depicts a perspective view of an opened end effector of theinstrument of FIG. 1;

FIG. 4A depicts a side cross-sectional view of the end effector of FIG.3, taken along line 4-4 of FIG. 3, with the firing beam in a proximalposition;

FIG. 4B depicts a side cross-sectional view of the end effector of FIG.3, taken along line 4-4 of FIG. 3, with the firing beam in a distalposition;

FIG. 5 depicts an end cross-sectional view of the end effector of FIG.3, taken along line 5-5 of FIG. 3;

FIG. 6 depicts an exploded perspective view of the end effector of FIG.3;

FIG. 7 depicts a perspective view of the end effector of FIG. 3,positioned at tissue and having been actuated once in the tissue;

FIG. 8 depicts a schematic view of an exemplary control circuit for usein the instrument of FIG. 1;

FIG. 9 depicts a perspective view of the handle assembly of theinstrument of FIG. 1, with a housing half removed;

FIG. 10 depicts a perspective view of drive assembly components from thehandle assembly of FIG. 9;

FIG. 11 depicts a perspective view of an elongate member from the driveassembly of FIG. 10;

FIG. 12 depicts a side, elevation view of an exemplary alternativeversion of an end effector suitable for incorporation in the instrumentof FIG. 1;

FIG. 13 depicts an enlarged, side view of the end effector of FIG. 12showing laterally separated, upwardly extending protrusions;

FIG. 14 depicts a cross sectional of the end effector of FIG. 12 takenalong line 14-14 of FIG. 13 showing the lateral protrusions;

FIG. 15 depicts a diagrammatic end view of the end effector of FIG. 12showing the lateral roll angle of the anvil;

FIG. 16 depicts an enlarged, perspective view of the anvil of FIG. 12with an engagement groove;

FIG. 17 depicts an enlarged, perspective view of the cartridge of FIG.12 with a protrusion and laterally separated, upwardly extendingprotrusions;

FIG. 18 depicts a top, diagrammatic view of the end effector of FIG. 12showing the angle of deflection of the anvil;

FIG. 19 depicts a side, elevation view of an alternative exemplaryversion of an end effector with an alignment member and lateralstabilization members; and

FIG. 20 depicts a cross-sectional view taken along the line 20-20 ofFIG. 19 showing the lateral stabilization members;

The drawings are not intended to be limiting in any way, and it iscontemplated that various embodiments of the invention may be carriedout in a variety of other ways, including those not necessarily depictedin the drawings. The accompanying drawings incorporated in and forming apart of the specification illustrate several aspects of the presentinvention, and together with the description serve to explain theprinciples of the invention; it being understood, however, that thisinvention is not limited to the precise arrangements shown.

DETAILED DESCRIPTION

The following description of certain examples of the invention shouldnot be used to limit the scope of the present invention. Other examples,features, aspects, embodiments, and advantages of the invention willbecome apparent to those skilled in the art from the followingdescription, which is by way of illustration, one of the best modescontemplated for carrying out the invention. As will be realized, theinvention is capable of other different and obvious aspects, all withoutdeparting from the invention. Accordingly, the drawings and descriptionsshould be regarded as illustrative in nature and not restrictive.

I. Exemplary Surgical Stapler

FIGS. 1-7 depict an exemplary surgical stapling and severing instrument(10) that is sized for insertion, in a nonarticulated state as depictedin FIG. 1, through a trocar cannula to a surgical site in a patient forperforming a surgical procedure. By way of example only, such a trocarmay be inserted in a patient's abdomen, between two of the patient'sribs, or elsewhere. In some settings, instrument (10) is used without atrocar. For instance, instrument (10) may be inserted directly through athoracotomy or other type of incision. Instrument (10) of the presentexample includes a handle portion (20) connected to a shaft (22). Shaft(22) distally terminates in an articulation joint (11), which is furthercoupled with an end effector (12). It should be understood that termssuch as “proximal” and “distal” are used herein with reference to aclinician gripping handle portion (20) of instrument (10). Thus, endeffector (12) is distal with respect to the more proximal handle portion(20). It will be further appreciated that for convenience and clarity,spatial terms such as “vertical” and “horizontal” are used herein withrespect to the drawings. However, surgical instruments are used in manyorientations and positions, and these terms are not intended to belimiting and absolute.

In some versions, shaft (22) is constructed in accordance with at leastsome of the teachings of U.S. Pat. App. No. 2014/0239038, entitled“Surgical Instrument with Multi-Diameter Shaft,” published Aug. 28,2014,the disclosure of which is incorporated by reference herein. Othersuitable configurations for shaft (22) will be apparent to those ofordinary skill in the art in view of the teachings herein.

Once articulation joint (11) and end effector (12) are inserted throughthe cannula passageway of a trocar, articulation joint (11) may beremotely articulated, as depicted in phantom in FIG. 1, by anarticulation control (13), such that end effector (12) may be deflectedfrom the longitudinal axis (LA) of shaft (22) at a desired angle (a).End effector (12) may thereby reach behind an organ or approach tissuefrom a desired angle or for other reasons. In some versions,articulation joint (11) enables deflection of end effector (12) along asingle plane. In some other versions, articulation joint (11) enablesdeflection of end effector along more than one plane. Articulation joint(11) and articulation control (13) may be configured in accordance withthe teachings of any of the numerous references that are cited herein.Alternatively, articulation joint (11) and/or articulation control (13)may have any other suitable configuration. By way of example only,articulation control (13) may instead be configured as a knob thatrotates about an axis that is perpendicular to the longitudinal axis(LA) of shaft (22).

In some versions, articulation joint (11) and/or articulation control(13) are/is constructed and operable in accordance with at least some ofthe teachings of U.S. Pat. No. 9,186,142, issued Nov. 17, 2015, entitled“Surgical Instrument End Effector Articulation Drive with Pinion andOpposing Racks,” filed on even date herewith, the disclosure of which isincorporated by reference herein. Articulation joint (11) may also beconstructed and operable in accordance with at least some of theteachings of U.S. Pat. App. No. 2014/0239038, published Aug. 8, 2014,the disclosure of which is incorporated by reference herein. Othersuitable forms that articulation joint (11) and articulation control(13) may take will be apparent to those of ordinary skill in the art inview of the teachings herein.

End effector (12) of the present example includes a lower jaw (16) and apivotable anvil (18). In some versions, lower jaw (16) is constructed inaccordance with at least some of the teachings of U.S. Pat. App. No.2014/0239044, published on Aug. 28, 2014, entitled “InstallationFeatures for Surgical Instrument End Effector Cartridge,” filed on evendate herewith, the disclosure of which is incorporated by referenceherein. Various exemplary alternative features, configurations, andoperabilities that may be incorporated into anvil (18) will be describedin greater detail below. In addition, anvil (18) may be constructed inaccordance with at least some of the teachings of U.S. Pat. App. No.2014/0239037, published Aug. 28, 2014, entitled “Staple Forming Featuresfor Surgical Stapling Instrument,” filed on even date herewith, thedisclosure of which is incorporated by reference herein. Other suitableforms that lower jaw (16) and anvil (18) may take will be apparent tothose of ordinary skill in the art in view of the teachings herein.

Handle portion (20) includes a pistol grip (24) and a closure trigger(26). Closure trigger (26) is pivotable toward pistol grip (24) to causeclamping, or closing, of the anvil (18) toward lower jaw (16) of endeffector (12). Such closing of anvil (18) is provided through a closuretube (32) and a closure ring (33), which both longitudinally translaterelative to handle portion (20) in response to pivoting of closuretrigger (26) relative to pistol grip (24). Closure tube (32) extendsalong the length of shaft (22); and closure ring (33) is positioneddistal to articulation joint (11). Articulation joint (11) is operableto communicate/transmit longitudinal movement from closure tube (32) toclosure ring (33).

Handle portion (20) also includes a firing trigger (28). An elongatemember (136) (shown in FIG. 11) longitudinally extends through shaft(22) and communicates a longitudinal firing motion from handle portion(20) to a firing beam (14) in response to actuation of firing trigger(28). This distal translation of firing beam (14) causes the staplingand severing of clamped tissue in end effector (12), as will bedescribed in greater detail below. Thereafter, triggers (26, 28) may bereleased to release the tissue from end effector (12).

FIGS. 3-6 depict end effector (12) employing an E-beam form of firingbeam (14) to perform a number of functions. It should be understood thatan E-beam form is just a merely illustrative example. Firing beam (14)may take any other suitable form, including but not limited tonon-E-beam forms. As best seen in FIGS. 4A-4B, firing beam (14) includesa transversely oriented upper pin (38), a firing beam cap (44), atransversely oriented middle pin (46), and a distally presented cuttingedge (48). Upper pin (38) is positioned and translatable within alongitudinal anvil slot (42) of anvil (18). Firing beam cap (44)slidably engages a lower surface of lower jaw (16) by having firing beam(14) extend through lower jaw slot (45) (shown in FIG. 4B) that isformed through lower jaw (16). Middle pin (46) slidingly engages a topsurface of lower jaw (16), cooperating with firing beam cap (44).Thereby, firing beam (14) affirmatively spaces end effector (12) duringfiring.

Some non-E-beam forms of firing beam (14) may lack upper pin (38),middle pin (46) and/or firing beam cap (44). Some such versions ofinstrument (10) may simply rely on closure ring (33) or some otherfeature to pivot anvil (18) to a closed position and hold anvil (18) inthe closed position while firing beam (14) advances to the distalposition. By way of example only, firing beam (14) and/or associatedlockout features may be constructed and operable in accordance with atleast some of the teachings of U.S. Pat. App. No. 2014/0239041,published Aug. 28, 2014, entitled “Lockout Feature for Movable CuttingMember of Surgical Instrument,” filed on even date herewith, thedisclosure of which is incorporated by reference herein. Other suitableforms that firing beam (14) may take will be apparent to those ofordinary skill in the art in view of the teachings herein.

FIG. 3 shows firing beam (14) of the present example proximallypositioned and anvil (18) pivoted to an open position, allowing anunspent staple cartridge (37) to be removably installed into a channelof lower jaw (16). As best seen in FIGS. 5-6, staple cartridge (37) ofthis example includes a cartridge body (70), which presents an upperdeck (72) and is coupled with a lower cartridge tray (74). As best seenin FIG. 3, a vertical slot (49) is formed through part of staplecartridge (37). As also best seen in FIG. 3, three rows of stapleapertures (51) are formed through upper deck (72) on one side ofvertical slot (49), with another set of three rows of staple apertures(51) being formed through upper deck (72) on the other side of verticalslot (49). Of course, any other suitable number of staple rows (e.g.,two rows, four rows, any other number) may be provided. Referring backto FIGS. 4A-6, a wedge sled (41) and a plurality of staple drivers (43)are captured between cartridge body (70) and tray (74), with wedge sled(41) being located proximal to staple drivers (43). Wedge sled (41) ismovable longitudinally within staple cartridge (37); while stapledrivers (43) are movable vertically within staple cartridge (37).Staples (47) are also positioned within cartridge body (70), abovecorresponding staple drivers (43). In particular, each staple (47) isdriven vertically within cartridge body (70) by a staple driver (43) todrive staple (47) out through an associated staple aperture (51). Asbest seen in FIGS. 4A-4B and 6, wedge sled (41) presents inclined camsurfaces that urge staple drivers (43) upwardly as wedge sled (41) isdriven distally through staple cartridge (37).

Various exemplary components, configurations, and operabilities that maybe incorporated into staple cartridge (37) will be described in greaterdetail below. Staple cartridge (37) may also be constructed and operablein accordance with at least some of the teachings of U.S. Pat. App. No.2014/0239044, published Aug. 28, 2014, the disclosure of which isincorporated by reference herein. Other suitable forms that staplecartridge (37) may take will be apparent to those of ordinary skill inthe art in view of the teachings herein.

With end effector (12) closed as depicted in FIGS. 4A-4B by distallyadvancing closure tube (32) and closure ring (33), firing beam (14) isthen advanced in engagement with anvil (18) by having upper pin (38)enter longitudinal anvil slot (42). A pusher block (80) (shown in FIG.5) is located at the distal end of firing beam (14), and is configuredto engage wedge sled (41) such that wedge sled (41) is pushed distallyby pusher block (80) as firing beam (14) is advanced distally throughstaple cartridge (37) when firing trigger (28) is actuated. During suchfiring, cutting edge (48) of firing beam (14) enters vertical slot (49)of staple cartridge (37), severing tissue clamped between staplecartridge (37) and anvil (18). As shown in FIGS. 4A-4B, middle pin (46)and pusher block (80) together actuate staple cartridge (37) by enteringinto vertical slot (49) within staple cartridge (37), driving wedge sled(41) into upward camming contact with staple drivers (43) that in turndrive staples (47) out through staple apertures (51) and into formingcontact with staple forming pockets (53) (shown in FIG. 3) on the innersurface of anvil (18). FIG. 4B depicts firing beam (14) fully distallytranslated after completing severing and stapling of tissue. It shouldbe understood that staple forming pockets (53) are intentionally omittedfrom the view in FIGS. 4A-4B; but staple forming pockets (53) are shownin FIG. 3. It should also be understood that anvil (18) is intentionallyomitted from the view in FIG. 5.

FIG. 7 shows end effector (12) having been actuated through a singlestroke through tissue (90). As shown, cutting edge (48) (obscured inFIG. 7) has cut through tissue (90), while staple drivers (43) havedriven three alternating rows of staples (47) through the tissue (90) oneach side of the cut line produced by cutting edge (48). Staples (47)are all oriented substantially parallel to the cut line in this example,though it should be understood that staples (47) may be positioned atany suitable orientations. In the present example, end effector (12) iswithdrawn from the trocar after the first stroke is complete, spentstaple cartridge (37) is replaced with a new staple cartridge, and endeffector (12) is then again inserted through the trocar to reach thestapling site for further cutting and stapling. This process may berepeated until the desired amount of cuts and staples (47) have beenprovided. Anvil (18) may need to be closed to facilitate insertion andwithdrawal through the trocar; and anvil (18) may need to be opened tofacilitate replacement of staple cartridge (37).

It should be understood that cutting edge (48) may sever tissuesubstantially contemporaneously with staples (47) being driven throughtissue during each actuation stroke. In the present example, cuttingedge (48) just slightly lags behind driving of staples (47), such that astaple (47) is driven through the tissue just before cutting edge (48)passes through the same region of tissue, though it should be understoodthat this order may be reversed or that cutting edge (48) may bedirectly synchronized with adjacent staples. While FIG. 7 shows endeffector (12) being actuated in two layers (92, 94) of tissue (90), itshould be understood that end effector (12) may be actuated through asingle layer of tissue (90) or more than two layers (92, 94) of tissue.It should also be understood that the formation and positioning ofstaples (47) adjacent to the cut line produced by cutting edge (48) maysubstantially seal the tissue at the cut line, thereby reducing orpreventing bleeding and/or leaking of other bodily fluids at the cutline. Furthermore, while FIG. 7 shows end effector (12) being actuatedin two substantially flat, apposed planar layers (92, 94) of tissue, itshould be understood that end effector (12) may also be actuated acrossa tubular structure such as a blood vessel, a section of thegastrointestinal tract, etc. FIG. 7 should therefore not be viewed asdemonstrating any limitation on the contemplated uses for end effector(12). Various suitable settings and procedures in which instrument (10)may be used will be apparent to those of ordinary skill in the art inview of the teachings herein.

It should be understood that instrument (10) may be configured andoperable in accordance with any of the teachings of U.S. Pat. No.4,805,823; U.S. Pat. No. 5,415,334; U.S. Pat. No. 5,465,895; U.S. Pat.No. 5,597,107; U.S. Pat. No. 5,632,432; U.S. Pat. No. 5,673,840; U.S.Pat. No. 5,704,534; U.S. Pat. No. 5,814,055; U.S. Pat. No. 6,978,921;U.S. Pat. No. 7,000,818; U.S. Pat. No. 7,143,923; U.S. Pat. No.7,303,108; U.S. Pat. No. 7,367,485; U.S. Pat. No. 7,380,695; U.S. Pat.No. 7,380,696; U.S. Pat. No. 7,404,508; U.S. Pat. No. 7,434,715; U.S.Pat. No. 7,721,930; U.S. Pub. No. 2010/0264193, now U.S. Pat. No.8,408,439, issued Apr. 2, 2013; and/or U.S. Pub. No. 2012/0239012, nowU.S. Pat. No. 8,453,914, issued Jun. 4, 2013. As noted above, thedisclosures of each of those patents and publications are incorporatedby reference herein. Additional exemplary modifications that may beprovided for instrument (10) will be described in greater detail below.Various suitable ways in which the below teachings may be incorporatedinto instrument (10) will be apparent to those of ordinary skill in theart. Similarly, various suitable ways in which the below teachings maybe combined with various teachings of the patents/publications citedherein will be apparent to those of ordinary skill in the art. It shouldalso be understood that the below teachings are not limited toinstrument (10) or devices taught in the patents cited herein. The belowteachings may be readily applied to various other kinds of instruments,including instruments that would not be classified as surgical staplers.Various other suitable devices and settings in which the below teachingsmay be applied will be apparent to those of ordinary skill in the art inview of the teachings herein.

II. Exemplary Motorized Drive Features

In the present example, instrument (10) provides motorized control offiring beam (14). FIGS. 8-11 show exemplary components that may be usedto provide motorized control of firing beam (14). In particular, FIG. 8shows an exemplary control circuit (100) that may be used to power anelectric motor (102) with electric power from a battery pack (104) (alsoshown in FIGS. 1-2). Electric motor (102) is operable to translatefiring beam (14) longitudinally as will be described in greater detailbelow. It should be understood that the entire control circuit (100),including motor (102) and battery pack (104), may be housed withinhandle portion (20). FIG. 8 shows firing trigger (28) as an open switch,though it should be understood that this switch is closed when firingtrigger (28) is actuated. Circuit (100) of this example also includes asafety switch (106) that must be closed in order to complete circuit(100), though it should be understood that safety switch (106) is merelyoptional. Safety switch (106) may be closed by actuating a separatebutton, slider, or other feature on handle portion (20).

Circuit (100) of the present example also includes a lockout switch(108), which is configured to be closed by default but is automaticallyopened in response to a lockout condition. By way of example only, alockout condition may include one or more of the following: the absenceof a cartridge (37) in lower jaw (16), the presence of a spent (e.g.,previously fired) cartridge (37) in lower jaw (16), an insufficientlyclosed anvil (18), a determination that instrument (10) has been firedtoo many times, and/or any other suitable conditions. Various sensors,algorithms, and other features that may be used to detect lockoutconditions will be apparent to those of ordinary skill in the art inview of the teachings herein. Similarly, other suitable kinds of lockoutconditions will be apparent to those of ordinary skill in the art inview of the teachings herein. It should be understood that circuit (100)is opened and thus motor (102) is inoperable when lockout switch (108)is opened. A lockout indicator (110) (e.g., an LED, etc.) is operable toprovide a visual indication of the status of lockout switch (108). Byway of example only, lockout switch (108), lockout indicator (110), andassociated components/functionality may be configured in accordance withat least some of the teachings of U.S. Pat. No. 7,644,848, entitled“Electronic Lockouts and Surgical Instrument Including Same,” issuedJan. 12, 2010, the disclosure of which is incorporated by referenceherein.

Once firing beam (14) reaches a distal-most position (e.g., at the endof a cutting stroke), an end-of-stroke switch (112) is automaticallyswitched to a closed position, reversing the polarity of the voltageapplied to motor (102). This reverses the direction of rotation of motor(102), it being understood that the operator will have released firingtrigger (28) at this stage of operation. In this operational state,current flows through a reverse direction indicator (114) (e.g., an LED,etc.) to provide a visual indication to the operator that motor (102)rotation has been reversed. Various suitable ways in which end-of-strokeswitch (112) may be automatically switched to a closed position whenfiring beam (14) reaches a distal-most position will be apparent tothose of ordinary skill in the art in view of the teachings herein.Similarly, various suitable forms that reverse direction indicator (114)may take will be apparent to those of ordinary skill in the art in viewof the teachings herein.

Handle portion (20) of the present example also includes a manual returnswitch (116), which is also shown in circuit (100). Manual return switch(116) is configured to act as a “bailout” feature, enabling the operatorto quickly begin retracting firing beam (14) proximally during a firingstroke. In other words, manual return switch (116) may be manuallyactuated when firing beam (14) has only been partially advanceddistally. Manual return switch (116) may provide functionality similarto end-of-stroke switch (112), reversing the polarity of the voltageapplied to motor (102) to thereby reverse the direction of rotation ofmotor (102). Again, this reversal may be visually indicated throughreverse direction indicator (114).

In some versions, one or more of switches (28, 106, 108, 112, 116) arein the form of microswitches. Other suitable forms will be apparent tothose of ordinary skill in the art in view of the teachings herein. Inaddition to or in lieu of the foregoing, at least part of circuit (100)may be configured in accordance with at least some of the teachings ofU.S. Pat. No. 8,210,411, entitled “Motor-Driven Surgical Instrument,”issued Jul. 3, 2012, the disclosure of which is incorporated byreference herein.

FIGS. 9-11 show various mechanical components that may be used toprovide motorized translation of firing beam (14). In particular, FIG. 9shows motor (102) housed in pistol grip (24) of handle portion (20). Itshould be understood that battery pack (104) (shown in FIGS. 1-2) mayalso be located in pistol grip (24) (e.g., below motor (102)) and/orelsewhere within handle portion (20). Motor (102) has a drive shaft(120) that is coupled with a gear assembly (122). Gear assembly (122)has an external casing (not shown) and is operable to drive an uppergear (126), which is shown in FIG. 10. Upper gear (126) meshes with apinion (128), which is rotatably supported by a pin (129) secured inhandle portion (20). It should therefore be understood that activationof motor (102) will ultimately rotate pinion (128) within handle portion(20).

As also shown in FIGS. 9-10, a translating rack (130) includes teeth(132) that mesh with pinion (128), such that rack (130) translateslongitudinally when pinion (128) rotates. As shown in FIG. 11, rack(130) is coupled with an elongate member (136), which extends throughshaft (22) and includes a distal end (138) that couples with theproximal end of firing beam (14). Elongate member (136) translateswithin shaft (22), such that elongate member (136) communicateslongitudinal motion of rack (130) to firing beam (14). It shouldtherefore be understood that activation of motor (102) will ultimatelytranslate firing beam (14) within end effector (12). In particular,motor (102) may drive firing beam (14) distally to sever tissue (90) anddrive staples (47) into tissue (90). A switch actuation arm (134)extends laterally from rack (130), and is positioned to engageend-of-stroke switch (112) when firing beam (14) reaches a distal-mostposition (e.g., after tissue (90) has been severed and staples (47) havebeen driven into tissue (90)). As noted above, this engagement ofend-of-stroke switch (112) automatically reverses motor (102) to returnfiring beam (14) from the distal-most position to the proximal position,enabling anvil (18) to be pivoted away from lower jaw (16) to releasetissue (90).

Use of the term “pivot” (and similar terms with “pivot” as a base)should not be read as necessarily requiring pivotal movement about afixed axis. In some versions, anvil (18) pivots about an axis that isdefined by a pin (or similar feature) that slides along an elongate slotor channel as anvil (18) moves toward lower jaw (16). In such versions,the pivot axis translates along the path defined by the slot or channelwhile anvil (18) simultaneously pivots about that axis. In addition orin the alternative, the pivot axis may slide along the slot/channelfirst, with anvil (18) then pivoting about the pivot axis after thepivot axis has slid a certain distance along the slot/channel. It shouldbe understood that such sliding/translating pivotal movement isencompassed within terms such as “pivot,” “pivots,” “pivotal,”“pivotable,” “pivoting,” and the like. Of course, some versions mayprovide pivotal movement of anvil (18) about an axis that remains fixedand does not translate within a slot or channel, etc.

In addition to or in lieu of the foregoing, the features operable todrive firing beam (14) may be configured in accordance with at leastsome of the teachings of U.S. Pub. No. 2012/0239012, now U.S. Pat. No.8,453,914, issued Jun. 4, 2013, the disclosure of which is incorporatedby reference herein; and/or in accordance with at least some of theteachings of U.S. Pub. No. 2012/0239012, now U.S. Pat. No. 8,453,914,issued Jun. 4, 2013, the disclosure of which is also incorporated byreference herein. Other suitable components, features, andconfigurations for providing motorization of firing beam (14) will beapparent to those of ordinary skill in the art in view of the teachingsherein. It should also be understood that some other versions mayprovide manual driving of firing beam (14), such that a motor may beomitted. By way of example only, firing beam (14) may be actuated inaccordance with at least some of the teachings of any otherpatent/publication reference cited herein.

III. Exemplary End Effector with Stabilization Features

In some instances it may be desirable to provide a mechanism forensuring that anvil (18) has clamped squarely against cartridge (37) andat an appropriate height relative to cartridge (37) prior to firingstaples (47) into tissue (90). For instance, in the event that anvil(18) and cartridge (37) clamp against tissue that might be unusuallythick in one area, and thinner in another, it may be desirable to alignanvil (18) against cartridge (37) even with uneven tissue clampedtherebetween. Upon clamping tissue, it may also be desirable to preventlateral rolling and/or lateral pivoting deflection of anvil (18)relative to cartridge (37).

FIG. 12 shows an exemplary end effector (212) operable for use with aninstrument such as instrument (10) shown in FIG. 1. For instance, endeffector (212) may be used in place of end effector (12). It will beappreciated that end effector (212) may be integrally formed witharticulation mechanism (11) or may be separately formed and removablyconnected to articulation mechanism (11). Other suitable variations willbe apparent to one of ordinary skill in the art in view of the teachingsherein. End effector (212) comprises an anvil (218) and lower jaw (216).Lower jaw (216) is operable to hold staple cartridge (237). In general,anvil (218) clamps against cartridge (237) to clamp tissue therebetween.Thereafter, staples within cartridge (237) may be fired into tissue andanchored in the tissue as a result of staples bending against anvil(218). With respect to clamping tissue and firing staples, end effector(212) is substantially similar to end effector (12) of FIG. 1. As anvil(218) contacts cartridge (237), features that will be discussed infurther below may be used to laterally stabilize anvil (218). As aresult, staples (such as staples (47)) may be fired from cartridge (237)through tissue and against anvil (218) without anvil (218) tippinglaterally relative to cartridge (237).

FIG. 13 shows an enlarged view of end effector (212). Cartridge (237)comprises a plurality of laterally separated, upwardly extendingprotrusions (250). As seen in FIG. 14, lateral protrusions (250)comprise two laterally spaced apart protrusions (250). Protrusions (250)are spaced apart such that when anvil (218) closes upon cartridge (237),anvil (218) does not rock laterally in relation to cartridge (237). Inthe illustrated version, protrusions (250) have a shallow, rounded shapethough it will be understood that any suitable shape for protrusions(250) may be used as would be apparent to one of ordinary skill in theart in view of the teachings herein. For instance, protrusions (250) mayhave a pointed or raised plateau shape. In some versions, protrusions(250) could be positioned along the length of cartridge (237).

FIG. 15 depicts a diagrammatic end view of end effector (212)illustrating a roll angle θ (213) of anvil (218) relative to alongitudinal axis (260) that extends through the center of end effector(212). It will be appreciated that roll angle θ (213) represents alateral roll either positive or negative from the 0° angle in the eventthat tissue (90) causes anvil (218) to roll while clamping againstcartridge (237). Lateral protrusions (250) are operable to provide twopoints of contact between anvil (218) and cartridge (237) such that rollangle θ (213) of anvil (218) remains approximately near 0° when anvil(218) contacts lateral protrusions (250). It will be understood that dueto clamping tissue between anvil (218) and cartridge (237), roll angle θ(213) may deviate from 0° but only slightly due to the dual contactpoints provided by protrusions (250). In other words, as anvil (218)closes upon cartridge (237), anvil (218) may laterally roll during themotion of closing upon cartridge (237); however, the contact betweenanvil (218) and protrusions (250) is operable to correct any lateralrolling of anvil (218). As a result, staple forming pockets (253) (seenin FIG. 16) align with apertures (251) (seen in FIG. 17) prior to firingstaples. Furthermore, protrusions (250) consistently establish where thepreload from anvil (218) will be applied against the upper deck ofcartridge (237). While the exemplary version shows protrusions (250)located on cartridge (237), it will be understood that in addition or inthe alternative, protrusions (250) may be positioned on anvil (218).Other suitable positions for protrusions (250) for laterally stabilizinganvil (218) will be apparent to one of ordinary skill in the art in viewof the teachings herein. FIG. 13 further shows anvil (218) having aprotrusion (219) operable to engage protrusions (250), thereby promotingfurther contact between cartridge (237) and anvil (218). Protrusion(219) is shaped as a generally planar surface though other suitableshapes may be used as would apparent to one of ordinary skill in the artin view of the teachings herein. Protrusion (219) can also be seen inFIG. 16.

It will also be appreciated that in some instances, as anvil (218)closes against cartridge (237) it may be desirable to prevent or correctlateral pivoting deflection of anvil (218) relative to cartridge (237).

FIG. 16 shows an underside view of anvil (218) showing an engagementgroove (270). Engagement groove (270) is shaped as an elongatedsemi-spherical groove within anvil (218), though it will be understoodthat engagement groove (270) may have any suitable shape for receiving aprotrusion (272) (shown in FIG. 17), which will be discussed in moredetail below. Groove (270) in the illustrated version comprises astraight curved portion (271) and spherical curved portions (273)flanking the straight curved portion to form groove (270). Groove (270)of the exemplary version is laterally centered along anvil (218) thoughother suitable positions for groove (270) may be used. In theillustrated version, engagement groove (270) is positioned such thatengagement groove (270) and protrusions (250) form a generallytriangular shape when anvil (218) is closed against cartridge (237). Ofcourse, this configuration is just a merely illustrative example, andthese features could be subject to various suitable alternativearrangements. Anvil (218) is shaped to laterally taper toward engagementgroove (270) in the present example, though any suitable shape for anvil(218) may be used as would be apparent to one of ordinary skill in theart in view of the teachings herein.

FIG. 17 shows cartridge (237) of end effector (212) with a protrusion(272). It will be appreciated that when anvil (218) closes againstcartridge (237), protrusion (272) fits within engagement groove (270).In particular, protrusion (272) may first contact spherical curvedportion (273) and slide to straight curved portion (271) as anvil (218)presses towards cartridge (237). It will be appreciated that engagementgroove (270) is sized larger than protrusion (272). As a result,protrusion (272) need not necessarily be perfectly aligned withengagement groove (270) for engagement groove (270) to catch protrusion(272). Cartridge (237) of the exemplary version laterally and verticallytapers towards protrusion (272) to form a narrowed tip, though it willbe understood that any suitable shape for cartridge (237) may be used aswould be apparent to one of ordinary skill in the art in view of theteachings herein.

Protrusion (272) is operable to catch a portion of engagement groove(270) such as spherical curved portion (273) where thereafter, thecurved contour of engagement groove (270) enables protrusion (272) toslide into a more central portion of engagement groove (270) such asstraight curved portion (271) thereby providing a fit between protrusion(272) and engagement groove (270). Once protrusion (272) and engagementgroove (270) fully engage each other, it will be appreciated that anvil(218) cannot deflect laterally relative to cartridge (237). Forinstance, in the exemplary version, the width of engagement groove (270)complements the diameter of protrusion (272) thereby preventingdeflection of anvil (218) and promoting anvil (218) and cartridge (237)alignment. However, the length of engagement groove (270) is longer thanthe diameter of protrusion (272) thereby promoting engagement ofprotrusion (272) and engagement groove (270) and furthermore promotingsliding of protrusion (272) into straight curved portion (271) ofengagement groove (270). It will further be understood that if anvil(218) is laterally pivotally deflected during closure, engagement groove(270) and protrusion (272) cooperate to guide anvil (218) intoalignment.

FIG. 18 shows longitudinal axis (260) extending through the center ofend effector (212). An angle of deflection β (262) represents the amountof deflection to the left or right of longitudinal axis (260) anvil(218) could experience in some scenarios during use. For instance,deflection of anvil (218) could occur in the event that thick orparticularly dense tissue is positioned between anvil (218) andcartridge (237) as anvil (218) clamps against cartridge (237) or whenthe density and/or thickness of tissue in the area between anvil (218)and lower jaw (216) varies across the width of anvil (218) and lower jaw(216). Of course, as discussed above, it will be appreciated that byengaging engagement groove (270) with protrusion (272), anvil (218)resists deflecting, thereby keeping angle of deflections β (262) atapproximately 0° relative to longitudinal axis (260). It will beunderstood that in some circumstances, slight deflection could occur,but generally speaking, protrusion (272) and engagement groove (270)help maintain angle of deflection β (262) at or near 0° relative tolongitudinal axis (260).

Furthermore, as can be seen in FIG. 16, anvil (218) has an anvil tip(220) where anvil tip (220) has a bent, sloped shape angled towardcartridge (237). It will be appreciated that the bent shape of anvil tip(220) complements the shape of cartridge (237) such that anvil (218)further resists deflecting relative to cartridge (237). While theexemplary version depicts anvil tip (220) having a bent shape, it willbe understood that anvil tip (220) need not necessarily have a bentshape and engagement groove (270) and protrusion (272) may be used insituations where anvil tip (220) is oriented in a straight mannerrelative to the rest of anvil (218). Indeed engagement groove (270) andprotrusion (272) may also be used in conjunction with cartridges (237)that might be straight rather than having an angled tip as seen, forinstance, in FIG. 12.

FIG. 19 depicts an alternative exemplary version of an end effector(312). It will be appreciated that end effector (312) may be usedinterchangeably with or in place of end effector (12, 212) as seen inFIGS. 1 and 12. End effector (312) comprises an anvil (318) and lowerjaw (316). Lower jaw (316) is in communication with a cartridge (337)operable to hold a plurality of staples in a substantially similarmanner relative to the lower jaw (16) and cartridge (37) shown in FIG.3. Anvil tip (320) is bent to generally complement the shape ofcartridge (237) though it will be understood that anvil tip (320) mayhave other suitable shapes.

End effector (312) further comprises a distally positioned anvilalignment member (370) and a lateral stabilization member (372). It willbe appreciated that alignment member (370) is operable to define spacingbetween anvil (318) and cartridge (337) at the distal end of endeffector (312). Furthermore, lateral stabilization member (372) isoperable to laterally stabilize anvil (318) against cartridge (337),which will be described in further detail below.

Alignment member (370) of the present example has a wedge shape with atriangular cross section. It will be understood that the triangularwedge shape of alignment member (370) is configured to complement thecontour of anvil (318) and cartridge (337). For instance, in someinstances, it may be desirable to maintain a particular distance betweenanvil (318) and cartridge (337) based on the type and/or thickness oftissue being placed between anvil (318) and cartridge (337). Alignmentmember (370) may thus be positioned between a portion of anvil (318) andcartridge (337) to prevent anvil (318) from closing against cartridge(337) further than what might be desired by the user. Furthermore, notonly does alignment member (370) prevent further closure of anvil (318)against cartridge (337), alignment member (370) allows anvil (318) tomaintain a specific distance from cartridge (337). Yet further,alignment member (370) fills the space between anvil (318) and cartridge(337) such that the distal end of anvil (318) and cartridge (337) withalignment member (370) placed in between forms an atraumatic blunt endthat may be used to urge end effector (312) through tissue withouteither anvil (318) or cartridge (337) inadvertently catching on tissue.In the exemplary version, anvil (318) and cartridge (337) have a planarprofile where anvil (318) and cartridge (337) meet alignment member(370). However, it will be appreciated that anvil (318) and cartridge(337) may have other suitable shapes as would be apparent to one ofordinary skill in the art in view of the teachings herein. Accordingly,alignment member (370) may also have any suitable shape to complementanvil (318) and cartridge (337). It will be appreciated that in someversions, alignment member (370) may be removable in relation to eitheranvil (318) or cartridge (337) or may be integrally formed with eitheranvil (318) or cartridge (337). In yet other exemplary versions, it willbe appreciated that alignment member (370) may be split such that aportion is connected to anvil (318) where another portion is connectedto cartridge (337). In some instances, end effector (312) may beprovided with a plurality of modular alignment members (370) havingdifferent shapes and sizes such that the user could, for instance, useone shape for alignment member (370) in one type of tissue and anothershape or size alignment member (370) in another type of tissue.

Lateral stabilization members (372) may also be seen in FIG. 19, andfurthermore a front, cross sectional view of lateral stabilizationmembers (372) may be seen in FIG. 20. Lateral stabilization members(372) comprise pieces of material operable to provide lateral contactbetween anvil (318) and cartridge (337). As can be seen in FIG. 20,lateral stabilization members (372) include two contact members with aspace provided therebetween. It will be appreciated that by placinglateral stabilization members (372) at opposite lateral sides of anvil(318) and cartridge (337), when anvil (318) closes on cartridge (337)during use, anvil (318) comes into contact with lateral stabilizationmembers (372). When in contact with lateral stabilization members (372),anvil (318) becomes laterally stabilized such that anvil (318) does notrock left or right relative to cartridge (337). In particular, lateralstabilization member (372) provides a surface of contact along lateralstabilization member (372) for anvil (318) to engage. As a result, itwill be understood that as anvil (318) closes on cartridge (337), eventhough anvil (318) may roll laterally due to pressing against tissue ofvarious thicknesses or densities, anvil (318) laterally straightens onceanvil (318) closes against lateral stabilization members (372). Lateralstabilization members (372) thus function similar to protrusions (250)of FIG. 13. In some exemplary versions, lateral stabilization members(372) may be positioned on anvil (318) rather than cartridge (337). Inyet other exemplary versions, lateral stabilization members (372) may beplaced on both anvil (318) and cartridge (337). Other suitable versionsof lateral stabilization members (372) will be apparent to one ofordinary skill in the art in view of the teachings herein. It will beappreciated that in some versions, lateral stabilization members (372)and/or alignment member (370) may be used in conjunction with endeffector (212) shown in FIG. 13, thereby providing further addedstaibilization.

IV. Miscellaneous

It should be understood that any one or more of the teachings,expressions, embodiments, examples, etc. described herein may becombined with any one or more of the other teachings, expressions,embodiments, examples, etc. that are described herein. Theabove-described teachings, expressions, embodiments, examples, etc.should therefore not be viewed in isolation relative to each other.Various suitable ways in which the teachings herein may be combined willbe readily apparent to those of ordinary skill in the art in view of theteachings herein. Such modifications and variations are intended to beincluded within the scope of the claims.

It should be appreciated that any patent, publication, or otherdisclosure material, in whole or in part, that is said to beincorporated by reference herein is incorporated herein only to theextent that the incorporated material does not conflict with existingdefinitions, statements, or other disclosure material set forth in thisdisclosure. As such, and to the extent necessary, the disclosure asexplicitly set forth herein supersedes any conflicting materialincorporated herein by reference. Any material, or portion thereof, thatis said to be incorporated by reference herein, but which conflicts withexisting definitions, statements, or other disclosure material set forthherein will only be incorporated to the extent that no conflict arisesbetween that incorporated material and the existing disclosure material.

Versions of the devices described above may have application inconventional medical treatments and procedures conducted by a medicalprofessional, as well as application in robotic-assisted medicaltreatments and procedures. By way of example only, various teachingsherein may be readily incorporated into a robotic surgical system suchas the DAVINCI™ system by Intuitive Surgical, Inc., of Sunnyvale, Calif.Similarly, those of ordinary skill in the art will recognize thatvarious teachings herein may be readily combined with various teachingsof any of the following: U.S. Pat. No. 5,792,135, entitled “ArticulatedSurgical Instrument For Performing Minimally Invasive Surgery WithEnhanced Dexterity and Sensitivity,” issued Aug. 11, 1998, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.5,817,084, entitled “Remote Center Positioning Device with FlexibleDrive,” issued Oct. 6, 1998, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 5,878,193, entitled “Automated EndoscopeSystem for Optimal Positioning,” issued Mar. 2, 1999, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 6,231,565,entitled “Robotic Arm DLUS for Performing Surgical Tasks,” issued May15, 2001, the disclosure of which is incorporated by reference herein;U.S. Pat. No. 6,783,524, entitled “Robotic Surgical Tool with UltrasoundCauterizing and Cutting Instrument,” issued Aug. 31, 2004, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.6,364,888, entitled “Alignment of Master and Slave in a MinimallyInvasive Surgical Apparatus,” issued Apr. 2, 2002, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 7,524,320,entitled “Mechanical Actuator Interface System for Robotic SurgicalTools,” issued Apr. 28, 2009, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 7,691,098, entitled “Platform Link WristMechanism,” issued Apr. 6, 2010, the disclosure of which is incorporatedby reference herein; U.S. Pat. No. 7,806,891, entitled “Repositioningand Reorientation of Master/Slave Relationship in Minimally InvasiveTelesurgery,” issued Oct. 5, 2010, the disclosure of which isincorporated by reference herein; U.S. Pub. No. 2013/0012957, entitled“Automated End Effector Component Reloading System for Use with aRobotic System, published Jan. 10, 2013, now U.S. Pat. No. 8,844,789,issued Sep. 30, 2014, the disclosure of which is incorporated byreference herein; U.S. Pub. No. 2012/0199630, entitled“Robotically-Controlled Surgical Instrument with Force-FeedbackCapabilities,” published Aug. 9, 2012, now U.S. Pat. No. 8,820,605,issued Sep. 2, 2014, the disclosure of which is incorporated byreference herein; U.S. Pub. No. 2012/0132450, entitled “Shiftable DriveInterface for Robotically-Controlled Surgical Tool,” published May 31,2012, now U.S. Pat. No. 8,616,431, issued Dec. 31, 2013, the disclosureof which is incorporated by reference herein; U.S. Pub. No.2012/0199633, entitled “Surgical Stapling Instruments with Cam-DrivenStaple Deployment Arrangements,” published Aug. 9, 2012, now U.S. Pat.No. 8,573,461, issued Dec. 10, 2013, the disclosure of which isincorporated by reference herein; U.S. Pub. No. 2012/0199631, entitled“Robotically-Controlled Motorized Surgical End Effector System withRotary Actuated Closure Systems Having Variable Actuation Speeds,”published Aug. 9, 2012, now U.S. Pat. No. 8,602,288, the disclosure ofwhich is incorporated by reference herein; U.S. Pub. No. 2012/0199632,entitled “Robotically-Controlled Surgical Instrument with SelectivelyArticulatable End Effector,” published Aug. 9, 2012, now U.S. Pat. No.9,301,759, issued Apr. 5, 2016, the disclosure of which is incorporatedby reference herein; U.S. Pub. No. 2012/0203247, entitled“Robotically-Controlled Surgical End Effector System,” published Aug. 9,2012, now U.S. Pat. No. 8,783,541, issued Jul. 22, 2014, the disclosureof which is incorporated by reference herein; U.S. Pub. No.2012/0211546, entitled “Drive Interface for Operably Coupling aManipulatable Surgical Tool to a Robot,” published Aug. 23, 2012, nowU.S. Pat. No. 8,479,969; U.S. Pub. No. 2012/0138660, entitled“Robotically-Controlled Cable-Based Surgical End Effectors,” publishedJun. 7, 2012, now U.S. Pat. No. 8,800,838, issued Aug. 12, 2014, thedisclosure of which is incorporated by reference herein; and/or U.S.Pub. No. 2012/0205421, entitled “Robotically-Controlled Surgical EndEffector System with Rotary Actuated Closure Systems,” published Aug.16, 2012, now U.S. Pat. No. 8,573,465, issued Nov. 5, 2013, Thedisclosure of which is incorporated by reference herein.

Versions of the devices described above may be designed to be disposedof after a single use, or they can be designed to be used multipletimes. Versions may, in either or both cases, be reconditioned for reuseafter at least one use. Reconditioning may include any combination ofthe steps of disassembly of the device, followed by cleaning orreplacement of particular pieces, and subsequent reassembly. Inparticular, some versions of the device may be disassembled, and anynumber of the particular pieces or parts of the device may beselectively replaced or removed in any combination. Upon cleaning and/orreplacement of particular parts, some versions of the device may bereassembled for subsequent use either at a reconditioning facility, orby a user immediately prior to a procedure. Those skilled in the artwill appreciate that reconditioning of a device may utilize a variety oftechniques for disassembly, cleaning/replacement, and reassembly. Use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

By way of example only, versions described herein may be sterilizedbefore and/or after a procedure. In one sterilization technique, thedevice is placed in a closed and sealed container, such as a plastic orTYVEK bag. The container and device may then be placed in a field ofradiation that can penetrate the container, such as gamma radiation,x-rays, or high-energy electrons. The radiation may kill bacteria on thedevice and in the container. The sterilized device may then be stored inthe sterile container for later use. A device may also be sterilizedusing any other technique known in the art, including but not limited tobeta or gamma radiation, ethylene oxide, or steam.

Having shown and described various embodiments of the present invention,further adaptations of the methods and systems described herein may beaccomplished by appropriate modifications by one of ordinary skill inthe art without departing from the scope of the present invention.Several of such potential modifications have been mentioned, and otherswill be apparent to those skilled in the art. For instance, theexamples, embodiments, geometrics, materials, dimensions, ratios, steps,and the like discussed above are illustrative and are not required.Accordingly, the scope of the present invention should be considered interms of the following claims and is understood not to be limited to thedetails of structure and operation shown and described in thespecification and drawings.

We claim:
 1. An apparatus, comprising: (a) a body; (b) a shaft incommunication with the body; (c) an end effector in communication withthe shaft, wherein the end effector is configured to drive seriallypositioned staples through tissue, wherein the end effector comprises:(i) an anvil, and (ii) a cartridge, wherein the anvil is operable topivot relative to the cartridge about a pivot axis, wherein thecartridge is positioned to drive staples upwardly toward the anvil, and(iii) a pair of protrusions comprising a first protrusion and a secondprotrusion, wherein the pair of protrusions are configured to preventlateral rocking of the anvil when the anvil pivots relative to thecartridge, wherein the pair of protrusions are pointed toward either theanvil or the cartridge, wherein the pair of protrusions are located in adistal region of the end effector, wherein the first protrusion islocated a first longitudinal distance from the pivot axis, wherein thesecond protrusion is located a second longitudinal distance from thepivot axis, wherein the first longitudinal distance is equal to thesecond longitudinal distance.
 2. The apparatus of claim 1, wherein adistal portion of the anvil is shaped to bend toward the cartridge. 3.The apparatus of claim 1, wherein the pair of protrusions comprises apair of laterally spaced apart bumps positioned at the distal end of thecartridge.
 4. The apparatus of claim 1, wherein the pair of protrusionsare located on the cartridge and is pointed toward the anvil, whereinthe anvil comprises at least one anvil protrusion that extends towardthe cartridge, wherein the at least one anvil protrusion is configuredto engage the pair of protrusions.
 5. The apparatus of claim 1, whereinthe anvil and the cartridge are shaped to laterally taper toward thedistal end of the end effector.
 6. The apparatus of claim 1, wherein theanvil comprises an engagement groove.
 7. The apparatus of claim 6,wherein the engagement groove has a length larger than its diameter. 8.The apparatus of claim 6, wherein the cartridge comprises an engagementprotrusion configured to engage the engagement groove.
 9. The apparatusof claim 8, wherein the engagement groove has a contoured curved shapeoperable to complement a curvature of the engagement protrusion.
 10. Theapparatus of claim 8, wherein the engagement groove has a length longerthan the engagement protrusion.
 11. The apparatus of claim 1, furthercomprising an alignment member configured to engage the anvil and thecartridge, wherein the alignment member has a wedge-like shape.
 12. Theapparatus of claim 1, further comprising an alignment member configuredto engage the anvil and the cartridge, wherein the alignment member isconfigured to provide the anvil and the cartridge with a planar contactsurface.
 13. The apparatus of claim 1, further comprising an alignmentmember configured to engage the anvil and the cartridge, wherein thealignment member is shaped to complement the contour of the anvil andthe contour of the cartridge.
 14. The apparatus of claim 1, furthercomprising a pair of lateral stabilization members laterally spacedapart between the anvil and the cartridge.
 15. An apparatus comprising:(a) a body; (b) an end effector in communication with the body, whereinthe end effector comprises an anvil and a cartridge, wherein the anvilis configured to pivot toward and away from the cartridge, wherein theanvil and the cartridge are configured to clamp against tissue; and (c)a lateral stabilization feature comprising a first contact member and asecond contact member, wherein the first contact member and the secondcontact member are laterally spaced apart from each other, wherein thefirst contact member and the second contact member are located at acommon longitudinal position of the end effector, wherein the lateralstabilization feature is positioned between the anvil and the cartridge,wherein the lateral stabilization feature is configured to maintainparallel alignment between a center plane of the anvil and a centerplane of the cartridge when the anvil pivots toward the cartridge,wherein at least part of the lateral stabilization feature is located ata distal end of the end effector.
 16. The apparatus of claim 15, whereinthe lateral stabilization feature comprises a plurality of laterallyaligned protrusions positioned between the anvil and the cartridge. 17.The apparatus of claim 15, wherein the end effector defines alongitudinal axis extending through the end effector, wherein a rollangle is defined as the lateral roll of the anvil relative to thelongitudinal axis, wherein the lateral stabilization feature isconfigured to maintain a substantially 0° roll angle when the anvilclamps against tissue and the cartridge.
 18. The apparatus of claim 17,wherein the anvil comprises a groove, wherein the cartridge comprises aball shaped to fit in the groove, wherein the groove and the ball areconfigured to engage to prevent lateral pivoting deflection of the anvilrelative to the longitudinal axis.
 19. An apparatus comprising: (a) abody; (b) an end effector in communication with the body, wherein theend effector comprises: (i) an anvil, and (ii) a cartridge, wherein theanvil is configured to pivot toward and away from the cartridge, whereinthe cartridge comprises a plurality of laterally positioned protrusionsconfigured to contact the anvil when the anvil pivots toward thecartridge, wherein the plurality of laterally positioned protrusions areconfigured to laterally stabilize the anvil against the cartridge; and(c) an alignment member positioned in between the anvil and thecartridge, wherein the alignment member comprises a first member and asecond member, wherein the first member and the second member are fixedto either the anvil or the cartridge, wherein the first member and thesecond member are laterally spaced apart from each other yet are locatedat a common longitudinal position, wherein the alignment member isconfigured to simultaneously engage the distal end of the anvil and thedistal end of the cartridge when the anvil is positioned to closeagainst the cartridge.